HomeMy WebLinkAboutBoard of Health January 9 20071 WHATCOM COUNTY COUNCIL
2 Board of Health
3
4 January 9, 2007
5
6 Council Chair Laurie Caskey - Schreiber called the meeting to order at 10:00 a.m. in
7 the Council Chambers, 311 Grand Avenue, Bellingham, Washington.
8
9
10 Present: Absent:
11 Barbara Brenner None
12 Dan McShane
13 Sam Crawford
14 Seth Fleetwood
15 Carl Weimer
16 L. Ward Nelson
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18
19 1. PUBLIC SESSION
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21 No one spoke.
22
23 2. PUBLIC HEALTH FINANCING
24
25 Regina Delahunt, Health Department Director, stated the local public health
26 community is aiming for all Boards of Health in the state to pass resolutions supporting the
27 recommendations of the Joint Select Committee. She gave a presentation (on file) and
28 discussed the history and purpose of the Joint Select Committee on Public Health Financing.
29 Public health is about a system larger than just the local public health districts. The
30 legislators on the committee were educated about the larger system. The committee,
31 State, and local health departments did an in -depth analysis statewide of what is being
32 done in public health and what else needs to be done. She read the presentation on the
33 model used for a health department, the six priority areas, and selecting priorities. To do
34 everything they need to do, and do it well, they would need an extra $300 million per year.
35 The committee also listed outcomes and measures. Even if the County doesn't get more
36 money from the State, the process was very valuable to get consensus on priorities and
37 gaps.
38
39 She read the presentation on the Joint Select Committee conclusions, Joint Select
40 Committee recommendations, recommended funding formula, and Joint Select Committee
41 conclusion about the first step. They are working hard now to get all the partners on board
42 with supporting the recommendations of this committee to get more dollars.
43
44 Nelson asked to amend the resolution, the second resolved statement, which
45 specifies funding of $100 million per biennium. Instead, change the funding amount to
46 specify that funding is recommended at $50 million annually, which is more consistent with
47 the committee recommendation. Delahunt stated they can.
48
49 Brenner asked if chronic disease includes mental health. Delahunt stated mental
50 health funding comes from a different source.
51
Board of Health, 1/9/2007, Page 1
Brenner stated this proposal is to create one source of funding. Delahunt stated the
funding is to work on the priorities that were listed. The public health community wasn't
talking about mental health.
Brenner stated she is talking about mental illness, which is a chronic disease. She
doesn't want to see mental illness funding being neglected.
McShane stated item four of the resolved statements could include mental illness.
Brenner asked why King County wasn't included in the graph. Delahunt stated their
public health system is very different, because they do a lot of clinical services. It's
inclusion would skew the results. The information on King County's spending is included
elsewhere in the report.
Nelson stated mental health and other disabilities are health issues. This Health
Board and the Public Health Advisory Board are working on a public health plan that
includes all those issues for the community. Traditionally, public health is related to the
overall, general health of the public, which is what this Joint Select Committee focused on.
He asked how assured they would be of continued funding if certain funding is
replaced with tobacco funding. He's not sure tobacco money would be stable money.
Delahunt stated a recommendation for funding is using a portion of tobacco sales tax that
now goes into the general fund. For this biennium, the feeling is that is a source of money
they can convince the legislature to let them use.
Regarding mental health, if they get $100 million, there is a prioritized list of how the
money will be spent. The money won't go far. There is over $300 million in need. They
are talking about adding health promotion staff and doing public education campaigns that
promote healthy behaviors such as nutrition and physical activity.
Fleetwood asked how much money is needed for bio- terrorism. Delahunt stated
quite a bit of funding would go to communicable disease work, which is related to bio -
terrorism and emergency response. There isn't a specific category for bio - terrorism. About
$12.5 million would go to communicable disease.
Fleetwood asked how the committee recommendations line up with the County's
current priorities. Delahunt stated the priorities were a consensus among all local health
jurisdictions. Each jurisdiction has its own specific emphasis. There is latitude for each
health jurisdiction to work within the different priorities. Locally, they don't have to add
money to a field that is already fully funded. Whatcom County is least funded in chronic
disease, and has a way to go in communicable disease.
Weimer asked if the bill has been drafted, and if there is a sponsor. Delahunt stated
the bill is being drafted by Rep. Schual- Berke. They are working on a proposal for a funding
mechanism.
Weimer asked if it will be supported by the Governor or State Department of Health.
Delahunt stated the Governor has put money in her budget for the State Department of
Health, which hasn't happened in a long time. They are trying to separate the legislative
budget and the Governor's budget. They have discussed the priorities with the Governor.
She is supporting the effort in the way she can at this point. She will support additional
funding from the legislature.
Boars! of Health, 1/9/2007, Page 2
Brenner stated the highest priority was that the counties who are doing the least will
get the most, according to her interpretation. Whatcom County has not been stagnating or
eroding. That's the report's conclusion. The number one priority seemed to say that those
counties that had done the least will get the most reward. Delahunt stated they talked
about not penalizing the counties that have been working hard.
Brenner asked about the $100 million funding. Delahunt stated Whatcom County
would probably get about $1 million per biennium.
Brenner stated amend the second resolved statement, "...to allocate additional funds
according to a fair distribution formula that acknowledges and enhances counties that have
been doing their share, based on public health needs...." In the recommendations, the
second item under delivery of public health services priorities implies that they are going to
give the money to the counties that aren't doing as much as Whatcom County. Delahunt
stated the money will be distributed on a modified per capita basis. This item says that any
jurisdiction not addressing an identified critical service need should apply its money first to
that service need.
Brenner asked if they can get extra money if they come up with new, creative
programs. Delahunt stated some funding would be set aside for multi - jurisdictional
projects.
Nelson moved to approve the resolution. He moved to amend the second
resolved statement, "...of $100 million ($50.miliion annually) to public...."
Motion to amend carried unanimously.
Motion to approve as amended carried unanimously.
3. HEALTH DEPARTMENT HOUSING PROGRAM OVERVIEW
Gary Williams, Environmental Health Supervisor, stated a local housing process was
done through the Homeless Coalition, City of Bellingham, and other groups a few years ago.
Over 40 agencies in Whatcom County are involved in housing. The process has been very
fragmented. When the legislature passed a funding program for low income housing and
homeless housing, the counties were able to charge a fee that is a revenue source for
housing. It has had a substantial impact to addressing needs.
House Bill (HB) 2060 funding is to provide operational costs, repair and retention,
and capital costs for low- income housing. They've funded almost $641,000 in operational
costs and $500,000 for capital costs in the past three years.
The Engrossed Second Substitute House Bill (ESSHB) 2163 dollars for the homeless
was meant to be spent in a consistent fashion with the County's homeless plan, which was
passed last December. They want to end homelessness. They should never quit trying to
end homelessness. The Whatcom County Housing Advisory Board is the public process for
making recommendations on distributing the funding. It is a more formal, structured, legal
process to start to organize how dollars are spent. The Homeless Coalition is wonderful. It
includes all the people who are doing the work, but it's not organizationally set up to
actually make decisions on funding. There is no accountability or process. The Housing
Advisory Committee has taken on that key function. They have been able to use the 2163
funds to support a planning process. The next phase is a more detailed inventory of
housing resources in the county. At the same time, the State decided to hold the dollars
Board of Health, 1/9/2007, Page 3
1 and put out a request for qualifications (RFQ) for proposed, systems- changing plans. They
2 reviewed best practices that are already in place in other locations.
3
4 The County recently received a grant of $1.4 million from the State, which is second
5 only to King County. Whatcom County is now competing with other, bigger counties for
6 housing dollars. The County has about $400,000 in capital money to be leveraged in a
7 major project.
8
9 (Clerk's Note: End of tape one, A.)
10
11 Williams continued to state that there is potential to leverage a lot of housing
12 resources.
13
14 Nelson asked if this is something the County would run or partner with other housing
15 advisors. Williams stated they propose establishing the Whatcom Homeless Services
16 Center. Negotiate the contract with the State for funding. When the County gets funding
17 from the State and the State Department of Community, Trade, and Economic Development
18 (CTED), it will craft a request for qualifications (RFQ) for an administrator to establish the
19 center. It will be a centralized housing point for all homeless services. They will also have
20 standard housing assessment form.
21
22 They will shift away from building shelters, which are a temporary measure.
23 Instead, they want to concentrate on the housing first model, which is to get people into
24 permanent housing.
25
26 They will also work to prevent people from becoming homeless in the first place by
27 providing such things as housing subsidies and rent supports when people are in immediate
28 risk of losing housing. They will also look at helping people become employed so the
29 subsidies can end.
30
31 The center will have a rapid service coordinator, who has the authority to rapidly
32 decide on the assistance available to an applicant. They will develop private housing
33 resources. Transitional housing programs are very expensive. The outcomes for folks in
34 transitional housing isn't good. Instead, put them into permanent housing. The challenge
35 is finding housing stock. They will work with landlords about mitigating risk and evictions.
36 That would open up a lot of housing. The service agencies will work on case management.
37
38 McShane stated it almost sounds like an insurance policy for renters. He asked if
39 renters get a better deal on rent by working with the center. Williams stated establishing
40 access and a relationship is more important. The model mitigation fund in Portland has few
41 charges against it.
42
43 Caskey- Schreiber stated Seattle is thinking about getting rid of their green areas
44 around the freeway because so many homeless stay there. People are crossing the
45 freeways and getting hit. It's a big safety issue. The public opinions about what to do
46 about homelessness are wide - ranging. Many homeless choose not to go to the shelters
47 because they can set up a home camp. She approves of this effort. Whatcom County can
48 begin to address homelessness before it becomes a huge problem. Williams stated
49 Whatcom County benefits from the best practices models that already exist. There are
50 different models to address the needs of the more challenging people. Establishing those
51 models is expensive, but they can do something small for Whatcom County.
52
Board of Health, 1/9/2007, Page 4
1 Nelson asked the goal of the center in reducing homelessness. Williams stated they
2 expect to decrease overall homelessness by 19 percent in three years, in Whatcom County.
3 They expect to decrease homelessness by 56 percent in nine years. Those are achievable
4 goals. That projection includes expected population growth. The measurement is the point -
5 in -time count data and the state and federal allocation of impact. They are using existing
6 projective rates to come up with that data.
7
8 McShane asked if there has been an official report regarding 1811 Mercer Street.
9 Williams stated there isn't yet. These are the people who government almost always fails.
10 Now, these people are in apartments and doing okay.
11
12 McShane asked if they will have a better demographic of distribution and success of
13 the different programs. He would like to see who is being helped the most. Williams stated
14 the rapid exit coordinator would be able to evaluate each client's need and send the person
15 to an agency that contractually has to take the client. That keeps clients from bouncing
16 among the different agencies. Some contracts will have higher projected performance
17 measures based on population and known ability, such as prevention. Contracts will vary
18 based on population and contract provider. There is an outcome process. They want to see
19 evidence that people remain in housing a year later.
20
21 McShane stated the Mercer Street project is expensive, but it saves money from
22 being spent on other programs and agencies. Williams stated the largest impact on
23 government will be the jail, which is Whatcom County's largest housing facility. Many
24 frequent visitors to the jail are chronic misdemeanants. Housing is a major issue with those
25 folks. Focus on reentry issues. Folks coming out of jails or hospitals will have a housing
26 resource. Link with community partners for support. National data shows that housing
27 reduces the number of people who are re- arrested or re- admitted to the hospital.
28
29 Nelson stated a concern is that people who leave the judicial system lose their
30 Medicaid eligibility. He asked the transition time for them to get that Medicaid eligibility
31 back. He asked if that money is put back into paying for housing. Williams stated the State
32 Department of Social and Health Services (DSHS) has the resources to work with jail
33 inmates before they are released to transition the benefit. Other dollars are used to help
34 needy folks who don't quality for DSHS.
35
36 Nelson stated those who are Medicaid eligible should receive funding that helps with
37 housing. He asked if that is diverted back into the program. Williams stated the client is
38 still responsible to provide their portion for rent.
39
44 Nelson stated money management is often the problem. Williams stated they are
41 helping with that issue. Most who receive entitlements can't afford to rent space in
42 Whatcom County. Their objective is to provide rent subsidies in some cases. Clients have
43 to contribute their portion.
44
45 Brenner asked if there is a way to send the client's housing money directly to the
46 agency working with the client. Williams stated they may do that in some cases.
47
48 Fleetwood asked the number of homeless in Whatcom County. Williams stated the
49 last count identified 1,255 homeless, including those people who are staying temporarily
50 with friends or family.
51
52 Fleetwood asked the 50 percent median income. Williams stated the amount is
53 based on the federal standard of income in terms of the poverty level. Fifty percent is a low
Board of Health, 1/9/2007, Page 5
1 number in terms of people being able to afford housing. A lot of the folks are at 30 percent
2 of median income.
3
4 Fleetwood asked if the service center funding in the future will continue to come
5 from the legislature's house bills. Williams stated it will.
6
7 Fleetwood asked if the County collects the maximum amount authorized from the
8 recording fee. Williams stated they do. Only ESSHB 2163 allows for administrative costs.
9
10 Caskey- Schreiber asked if they will help homeowners who are in danger of losing
11 their homes. Williams stated the prevention program for helping people remain in housing
12 will include owners and renters.
13
14 Homeless housing is an issue at the State level. The State sees housing as a key
15 factor in controlling other State costs. The problem is that the State does not see the local
16 efforts as a cost share. For the first time, they recognize that they can end homelessness.
17
18 Brenner asked the median income. Williams stated he would provide that
19 information.
20
21 Delahunt stated Mr. Williams has done a terrific job of pulling together this program,
22 which didn't exist two years ago. The advisory committee is now really working together.
23
24 Fleetwood stated his friend Greg Winter wrote the grant. Williams stated he did. He
25 did a super job. Mr. Winter also has done activities with the affordable housing. They are
26 linked issues. Gail DeHoag with the Opportunity Council and the Homeless Coalition were
27 great contributors.
28
29
30 ADJOURN
31
32 The meeting adjourned at 11:55 a.m.
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36 ]ill Nixon, Minutes Transcription
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46 Danar- )Provirr�r . , i G'o�unc' lerk Lurie Caskey - Schreiber, Council Chair
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Board of Health, 1/9/2007, Page 6